Trikomoniasis

Trikomoniasis, also known as trichomoniasis, is a common sexually transmitted infection caused by the flagellated protozoan parasite Trichomonas vaginalis. The infection primarily affects the urogenital tract and is transmitted through sexual contact with an infected person. In newborns, maternal transmission during birth can occur, but nonsexual transmission is rare.

Most infections are asymptomatic, especially in men. When symptoms occur, women commonly report vaginal discharge that may be frothy and malodorous, itching or irritation of the vagina, and sometimes dyspareunia or dysuria. Men may have urethral discharge or discomfort, but symptoms are often mild or absent. A classic exam finding in women can be a reddened cervix with punctate lesions known as strawberry cervix, though this is not universal.

Diagnosis relies on laboratory testing. Nucleic acid amplification tests on vaginal swabs or urine samples are highly sensitive and specific. Wet mount microscopy and culture can be used but have lower sensitivity. In many settings, NAATs are the preferred method due to their accuracy and rapid results.

Treatment involves antiprotozoal medication, most commonly metronidazole or tinidazole. Regimens may include a single-dose or a longer course, and sexual partners within the recent past should be treated simultaneously to prevent reinfection. Patients should avoid alcohol during and for 24 hours after metronidazole therapy. The infection is treated similarly in pregnancy, with medical guidance.

Prevention focuses on safe sex practices, including consistent condom use, reducing the number of sexual partners, and regular screening in sexually active individuals. Prompt diagnosis and treatment help reduce transmission and complications.